1

Provincial Technical Officers and fellows of FELTP assigned at the Disease Surveillance, Response Units

(DSRU’s) are working with provincial, and district health authorities on event based disease surveillance and

outbreak response. DSRUs are sharing the disease surveillance data, outbreak reports and activities of FELTP

fellows to the Federal Disease Surveillance and Response Unit (FDSRU) at the Field Epidemiology and

Disease Surveillance Division (FEDSD) National Institute of Health (NIH) Islamabad on weekly basis.

COVID-19 Surveillance

PDSRUs in Provinces are working with the

provincial department of health on COVID-19

surveillance, response and contact tracing since

February, 2020 in Pakistan. FELTP fellows Alumni

are actively involved in COVID-19 Surveillance

throughout Pakistan. Data is being shared with

FDSRU on daily basis and a SITRIP is being issued

by FEDSD National Institute of Health Islamabad

FDSRU has developed a mechanism for tracking of

travelers from other countries to Pakistan since 02

February 2020. Daily flights data from international

airports in Pakistan is being shared by the Central

Health establishment (CHE) Islamabad with FDSRU

teams who conduct daily calls on given contact

numbers of the travelers to ask about their health

status, advise them for immediate contact at the

nearest designated hospital in case of COVID-19

symptoms. Total 48,752 travelers have been traced

and contacted by June 27, 2020.

Table-1: Weekly Surveillance data COVID-19 by June 27, 2020

Province/

Region

Suspected cases

reported at

hospitals

Lab Update Hospital Update

Cumulative tests performed

(Cumulative)

Tested positive

cases

(Cumulative)

Still

admitted

Discharged/Recovered Expired

AJK 15,015 15,350 1,027 119 465 28

Baluchistan 42,920 47,735 10,261 48 3,810 114

GB 11,939 13,197 1,423 48 1,062 24

Islamabad 115,791 118,179 12,395 252 6,532 122

KP 111,022 141,436 25,380 977 12,149 914

Punjab 472,565 477,107 74,202 2,523 25,162 1,673

Sindh 414,248 426,149 78,267 1,375 43,444 1,243

Total 1,183,500 1,239,153 202,955 5,342 92,624 4,118

PDSRU SINDH

Total 86,900 confirmed COVID-19 cases were

reported from Sindh until June 27,2020. Most of

these cases were reported from Karachi District

(n=68,443) followed by District Hyderabad

(n=2819), District Sukkur (n=2486) and District

Ghotki (n=2087). Age group 50-59 has the highest

attack rate (422/100,000) followed by 60-69 years

age group (353/100,000), 30-39 years age group

(339/100,000), 70+ years’ age group (337/100,000)

and 40-49 years age group (313/100,000).

Federal Disease Surveillance and Response Unit

Field Epidemiology & Disease Surveillance Division

National Institute of Health (NIH) Islamabad

WEEKLY FIELD EPIDEMIOLOGY REPORT

Volume 2-- Issue 24 June 21-27, 2020 Date: June 29, 2020

Volume02 -- Issue 24 June 21-27, 2020 Date: June 29, 2020

2

Figure-1: Sindh - District-wise distribution of COVID-19 cases (June 27, 2020)

Figure-2: Sindh – Age group-wise Attack Rates /100,000 population (June 27, 2020)

PDSRU Punjab

PDSRU Punjab has reported total 472,565 suspected

cases of COVID-19 and out of these 74,202 were lab

confirmed COVID-19 cases up to June 27, 2020

while results of 479 suspects were awaited. District

Lahore has the highest number of confirmed cases

(n=145601) followed by District Rawalpindi

(n=22771), District Multan (n=19970), District

Faisalabad (n=18437) and Gujranwala (n=12461)

respectively. Age group 31-45 years has the highest

number of cases (n=22978) followed by age group

16-30 (n=21285) and age group 46-60 years

(n=15897)

Figure-3: Geographical Distribution of COVID-19 Cases in Punjab Province (Cumulative up to week 26)

25

74

285

339313

422

353337

0

50

100

150

200

250

300

350

400

450

Volume02 -- Issue 24 June 21-27, 2020 Date: June 29, 2020

3

Figure-4: Age wise distribution of COVID-19 cases in Punjab up to June 27, 2020

PDSRU - Baluchistan province

The department of Health Baluchistan has reported

10,376 positive cases of COVID-19 and 116 deaths

till June 27, 2020. 3,939 cases have recovered. Total

101,441 travelers were screened, 48,194 suspects

were identified and based on test results, 37,818

suspects were declared negative for COVID-19. Age

group 30-44 age group has the highest attack rate per

100000 Population (AR=35.07%) followed by 15-29

age group (AR=27.98%) and 45-59 age group

(AR=19.16%).

Figure-5: Baluchistan - Detail of suspected and confirmed COVID-19 cases (Cumulative up to June 27, 2020)

Figure-6: Baluchistan –Attack rates /100,000 population in different age groups (up to June 27, 2020)

3436

2128522978

15897

7665

1319

0

4000

8000

12000

16000

20000

24000

28000

1-15y 16-30 31-45 46-60 61-75 >75

No

. o

f C

ases

Age Groups

101441

48194

37818

103766321

90 1163939

0

20000

40000

60000

80000

100000

120000

Total Screened SuspectedCases

Negative Positive Active Cases ResultsPending

Deaths Recovered

10.66

27.98

35.07

19.16

8.85

0

20

40

Volume02 -- Issue 24 June 21-27, 2020 Date: June 29, 2020

4

PDSRU- Gilgit-Baltistan (GB)

PDSRU GB has reported total 12,064 suspected

cases of COVID-19 and out of these 319 were lab

confirmed COVID-19 cases up to June 27, 2020

while results of 250 suspected cases are still awaited.

11,595 samples were processed and 10,153 suspects

were declared negative for COVID-19. 1099 cases

recovered from COVID-19 while 24 cases expired.

District Hunza has the highest number of cases

(n=64) followed by District Skardu (n=59) and

District Astore (n=52).

Table -2 Detail of number of samples, confirmed Covid-19 cases & Deaths in GB up to June 27, 2020

District

Number of

Samples

Negative Total Samples

Processed

Positive

Awaited

Recovered

Expired

Samples

Discarded

Astore 2377 2057 2363 52 08 250 04 06

Diamer 445 370 443 29 01 42 02 01

Ghanche 982 831 878 04 34 42 01 70

Ghizer 617 561 610 32 07 17 00 00

Gilgit 3123 2582 3007 49 46 363 13 70

Hunza 1030 839 1008 64 18 104 01 04

Kharmang 223 181 198 01 11 16 00 14

Nagar 920 758 916 28 02 128 02 02

Shigar 385 327 357 01 05 29 00 23

Skardu 1962 1647 1815 59 118 108 01 29

Grand Total 12064 10153 11595 319 250 1099 24 219

Figure-7: GB-District-Wise distribution of confirmed COVID-19 cases up to June 27, 2020

PDSRU-AJK

PDSRU AJK has reported total 15,620 suspected

cases of COVID-19 and out of these 1049 were lab

confirmed COVID-19 up to June 27, 2020 while

results of 163 suspected cases still awaited. District

Muzaffarabad has the highest number of cases

(n=432) followed by District Mirpur (n=154),

District Bhimber (n=118) and District Bagh (n=86).

Table -3: Distribution of suspected and confirmed Covid-19 cases in AJK up to June 27,2020

5259

4

32

49

64

1

28

0

30

60

90

Astore Skardu Ghanche Ghizer Gilgit Hunza Kharmang Nagar

No

. o

f C

ases

Districts

Total Suspected Cases Lab Tests Conducted Lab Confirmed Cases Lab Results Awaited Active Cases Recovered

15,620 15,620 1049 163 501 520

Volume02 -- Issue 24 June 21-27, 2020 Date: June 29, 2020

5

Figure-8: AJK-District-Wise distribution of confirmed COVID-19 cases up to June 27, 2020

PDSRU-KPK

PDSRU KPK has reported total 96,229 suspected

cases of COVID-19 and out of these 21,997 were lab

confirmed COVID-19 up to June 20, 2020 while 821

patients expired. District Peshawar has the highest

number of cases & deaths (n=36783) followed by

District Swat (n=9699), District Malakand (n=5092)

and District Mardan (n=4648). Age group > 80 years

has the highest attack rate/100,000 (AR=360.6)

followed by 70-79 years age group (AR=183) and

50-59 years age group (AR=138.1).

Figure-9: Geographical Distribution of COVID-19 Cases in KPK Province (Cumulative up to Week 26)

Figure 10: KPK –Attack rates /100,000 population in different age groups (up to June 27, 2020)

432

20

84 77 86

17

52

154

118

0

80

160

240

320

400

480

Muzaffarabad Hattian Bala Kotli Poonch Bagh Havaili Pallandri Mirpur Bhimber

No

. o

f C

ases

Districts

11.7 21.3

85.5

152.1 152.2 161.6138.3

212.3

411.3

0

50

100

150

200

250

300

350

400

450

0 – 9 10 – 19 20 – 29 30 – 39 40 – 49 50 – 59 60 – 69 70 – 79 >80

Att

ack r

ate

/100,0

00

Age Groups

Volume 2-- Issue 24 June 21-27, 2020 Date: June 29, 2020

PDSRU Merged Areas KPK

PDSRU Merged Areas KPK has reported total

14,263 suspected cases of COVID-19 and out of

these 2006 were lab confirmed COVID-19 up to June

27, 2020 while results of 110 suspected cases still

awaited. District Khyber has the highest number of

confirmed COVID-19 cases (n=1019) followed by

District Bajour (n=458) and District Kurram

(n=378). In all the districts cases declined from week

24 onwards. Age group 26-50 years has the highest

number of cases (n=1141) followed by 0-25 years

age group (n=478)

Figure-11: Week-wise comparison of COVID-19 Cases - Districts of Merged Area KPK (up to Week 26)

Figure-12: Age wise distribution of Covid-19 cases in Merged Areas, KP (June 27, 2020)

Communicable Disease Surveillance

Influenza Suspected/Confirmed:

In 2018, total 3221 and in 2019 total 100

Suspected/confirmed Influenza cases reported from

PDSRUs/RDSRUs. In week 25, no suspected cases

were reported.

Diphtheria Surveillance:

During 2018 total 464 and during 2019 total 614-

suspected cases of Diphtheria were reported. In week

26, 01 case was reported from KPK.

Dengue Surveillance:

In 2018, total 3204 Dengue cases reported from

Sindh Total 24,610 cases reported which includes 48

new case reported from Baluchistan. In week 25, 02

case reported from Punjab. No cases reported from,

Merged Areas, ICT, Sindh, KP, AJK & Baluchistan

CCHF Surveillance: In 2018, total 63 CCHF

(suspected and confirmed) cases were reported from

DSRUs and 75 cases have been reported in 2019. 01

new case reported in this week from Punjab

31 33 4046

63

10 19

84

55 4539

24

8

15

1

5 20

5730

35 9

31

97

0

0

62

1

0

6

11

22

37

0

20

40

60

80

100

120

140

160

180

week 20 week 21 week 22 week 23 week 24 week 25 week 26

No

. of

Cas

es

BAJOUR KHYBER MOHMAND ORAKZAI KURRAM NORTH WAZIRISTAN SOUTH WAZIRISTAN

478

1141

387

0

200

400

600

800

1000

1200

0 to 25 years 26 to 50 years 51 years & above

No

. o

f C

ases

Age Groups

Volume 2-- Issue 24 June 21-27, 2020 Date: June 29, 2020

Table-4: Weekly and Cumulative Diseases Updates June 27, 2020

Table 5: Dengue cases reported in 2017, 2018, month-wise distribution in 2019 & current week (All provinces and regions)

Month KPK Sindh AJK ICT TDs - KP Baluch Punjab Total

Jan–Dec 2017

18,857 2,884 6 120 406 86 579 22,938

Jan-Dec 2018 332 2088 1 0 175 69 539 3204 Jan-Dec 2019 5214 2937 506 2847 1484 2841 8826 24547

Total 24403 7909 513 2967 2065 3057 9944 50750

27-06-2020 0 0 0 0 0 0 2 2 Total (2020) 03 0 0 0 02 185 10 200

Extensive drug Resistant (XDR) Typhoid Fever Surveillance in Sindh Province

In Karachi total 12,708 cases of extensive drug

resistance typhoid fever were reported from January

01, 2017 to June 27, 2020. During current week total

28 cases of XDR typhoid fever were reported from

different hospitals in Karachi. The XDR Typhoid

cases were reported mostly among the children and

maximum number of XDR cases 7774 (40%) were

reported in the age group 0-4 years. The overall

attack rate was 63/100,000. The age group 0-4 years

was the most affected age group (attack rate

191/100,000) followed by age group 5-9 years (AR

138/100,000). Females have higher attack rate

73/100,000 compared to Males

Table-6: Number of XDR Typhoid fever cases Karachi from January 1, 2017 to June 27, 2020 Year Year XDR Cases

Jan to December 2017 175

Jan to December 2018 3712

Jan to December 2019 7088

January 01, to June 27 ,2020 2020 1733

Total 12708

Figure 13: Week-wise number of XDR Typhoid fever cases in Karachi, from January 1, 2017 to June 27, 2020

0

50

100

150

200

250

300

Wee

k 1

Wee

k 5

Wee

k 9

Wee

k 1

3

Wee

k 1

7

Wee

k 2

1

Wee

k 2

5

Wee

k 2

9

Wee

k 3

3

Wee

k 3

7

Wee

k 4

1

Wee

k 4

5

Wee

k 4

9

Wee

k 1

Wee

k 5

Wee

k 9

Wee

k 1

3

Wee

k 1

7

Wee

k 2

1

Wee

k 2

5

Wee

k 2

9

Wee

k 3

3

Wee

k 3

7

Wee

k 4

1

Wee

k 4

5

Wee

k 4

9

WE

EK

1

WE

EK

5

WE

EK

9

WE

EK

13

WE

EK

17

WE

EK

21

Jan FebMarAprMayJuneJulyAugSeptOctNovDec Jan FebMarAprilMayJuneJulyAugustSeptOctNovDecJan Feb MarAprMayJunw

2018 2019 2020

Nu

mb

er o

f case

s

Epidemiological Months and Weeks

Disease Total Cases in 2019 June 21-27, 2020 Total Cases in 2020

1 CCHF 75 0 03 2 Varicella 1,264 0 204 3 Dengue 24,547 2 200 4 Chikungunya 0 0 0 5 Measles 6,781 65 1114

6 Diphtheria 614 1 96 7 Suspected / confirmed Seasonal

Influenza 100 0 9

Volume02 -- Issue 24 June 21-27, 2020 Date: June 29, 2020

8

XDR Typhoid Surveillance Data Sindh-Province (Excluding Karachi)

Total 6349 Salmonella Typhoid cases reported from

the November 2016 to June 27, 2020 from different

districts of Sindh province (excluding Karachi).

Among these cases 4892 were Extensive Drug

Resistant cases. Out of these cases, 70.2% (n=3434)

reported from District Hyderabad. The most affected

age group was 0 to 4 years (n=1331) with attack rate

45.1 per/10000 population followed by 5-9 years of

age group (n= 988) with attack rate 33.7/10000

population. Over all attack rate is 15.7/10000

population (n=3434).

Table 7: Extensive drug Resistant (XDR) Typhoid Fever Surveillance Hyderabad and other districts

Figure 14:XDR Typhoid Cases District Hyderabad Nov-2016 to June 27, 2020

0

50

100

150

200

250

N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J

Year -16

Year-17 Year -18 Year-19 Year-20

No

of

case

s

Month wise cases

Year Hyderabad Other District Total

2016 12 0 12

2017 485 4 489

2018 891 207 1098

2019 1645 998 2643

January 01 – June 20, 2020 382 239 621

Current week (June 21-27,

2020)

19 10 29

Total 3434 1458 4892